Many readers may be interested in knowing that Dr. Charles Ryan (a medical oncologist at the University of California, San Francisco) is now blogging about prostate cancer in his capacity as one of the “centers of excellence” editors for the UroToday web service.

The following are links to the first three blog posts by Dr. Ryan, all dealing with issues relevant to the management of advanced forms of prostate cancer:

2 Responses

Fascinating; thank you for posting. The “virility triad” post ties in to BAT interestingly indeed. In my (highly individual, not recommended for others) active surveillance regime on atorvastatin and metformin I have noticed symptoms of reduced androgens (as might be expected) so I might individualize it further with 6 months off and see which way the PSA needle moves. … (How hard it moves up, I should say.)

The blog about “Why is my 3 + 3 = 6” prostate cancer patient dying is completely irrational. How could an experienced clinician draw such definitive conclusions about the patients he has in his practice in the situation he is describing. All of them were on AS. If any were not he does not mention that. Also, it is well known that 30%-40% of biopsy-proven prostate cancer is later upgraded to a higher Gleason score. So, his paper could have easily been titled “30%-40% of AS patients harboring > 3 + 3 = 6 prostate cancer do extremely well on AS.” He also does not know that these patients at some point did not develop more aggressive disease down the road.

For him to claim his “3 + 3 = 6” patients are dying of prostate cancer without complete proof they were actually “3 + 3 = 6” is nuts on his part. I can’t believe he would write such a paper.

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